María

María Pu Castro is 60 years old and has been a Traditional Birth Attendant in Santa Lucia la Reforma, a remote village in Guatemala, for many years.

“In my work I have to estimate how many months pregnant the woman is; when her time comes, I deliver the baby in her home; I prepare her traditional steam bath, find the medicinal plants we use for her baths after delivery, and bathe the mother and baby afterwards.”

In María’s indigenous community, far from hospitals and trained health workers, the majority of women will give birth at home. Health Poverty Action is working with Traditional Birth Attendants to ensure they have the training and tools to deliver babies as safely as possible.

María is taking part in our training sessions, organised with staff from the local Ministry of Health. “I enjoy learning new things,” she says. “I’m learning about early detection of danger signs and now when I spot something wrong during a patient’s check-up, I refer her to the health centre, or sometimes to the nearest hospital in Santa Cruz del Quiché. I know now how important this can be to prevent maternal deaths.”

As a result, María has begun to change the way she works with patients: “Now, if I have a woman with strong headaches, or swelling in her feet, I refer her at once to the Ministry of Health. If it’s a woman’s first baby, I know now to wait for only 8 hours after she’s begun to go into labour, and if the baby hasn’t come by then, to get her to a doctor. We talk about how to negotiate with the family, to get her to medical attention in these cases.”

Negotiating with the family is one of the hardest parts of her work: the health facilities, staffed by non-indigenous workers who don’t speak their language, are perceived as frightening and discriminatory places. But as the training workshops bring together indigenous community leaders like María and health workers, this is starting to change.

“Now, the Health Centre works better than it used to. Staff used to ignore us, but now they treat us better, and they also receive us if we turn up in an emergency at night. Nowadays they tell us we’re welcome, to come in and sit down; it didn’t used to be like that.”